Rhodiola grows in cold regions and at high altitudes in Europe and Asia, where its roots have traditionally been used to increase resistance to physical stress.

While there are more than 200 species of rhodiola, Rhodiola rosea is considered preferable, because it contains rosavins. Supplements generally contain a minimum of 3% rosavins.

Rhodiola is considered an adaptogen, which is an agent that is believed to normalize functioning and stimulate healing of cells. It has been used to prevent fatigue and enhance physical and mental performance. Rhodiola may also provide benefit in bladder cancer, lung disease, and exercise and mental performance, but more studies are needed to confirm these findings.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Rhodiola is considered an adaptogen. Adaptogens reportedly regulate stress resistance and increase performance, energy, and endurance. Initial results for use of rhodiola as an adaptogen are promising, but further research is required before conclusions can be made.

C

Rhodiola is popularly used for anxiety and other mood-related disorders. In human research, rhodiola was found to reduce cortisol, a hormone whose levels increase during stress. Based on preliminary research, rhodiola may be beneficial in reducing anxiety; however, large, well-designed clinical trials are needed before a conclusion can be made.

C

Preliminary research suggests that rhodiola may benefit patients with bladder cancer. Well-designed studies are needed before a conclusion can be made.

C

Rhodiola has been used traditionally to reduce depression. In preliminary study of patients with mild-to-moderate depression, the SHR-5 standardized extract of rhodiola decreased symptoms of depression. Further research is needed before conclusions can be made.

C

Limited study of rhodiola for exercise performance enhancement is promising; however, additional studies are needed before a conclusion can be made.

C

Rhodiola has been used to increase energy and reduce fatigue. More well-designed studies are required.

C

Rhodiola has been hypothesized to protect against injury caused by too little oxygen. Review of human research indicates that rhodiola may improve oxygenation. More high quality research is needed.

C

Early study suggests that rhodiola may protect the lungs from acute injury. Further studies are needed before a firm conclusion may be made.

C

Early study suggests that rhodiola may benefit learning, memory, and mental performance. Well-designed studies are needed before a conclusion may be made.

C

Preliminary study suggests that the combination product Dzherelo (containing rhodiola) may benefit patients with tuberculosis. Additional research evaluating rhodiola alone is needed before a conclusion can be made.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Although various doses have been studied, there is no proven safe or effective dose for rhodiola. Typically, 100 to 600 milligrams of rhodiola has been used. High doses are considered to be 1,000 milligrams or more daily. Some sources suggest that rhodiola should be taken on an empty stomach and should not be used continuously.

As an adaptogen, 100-300 milligrams of rhodiola (standardized to 1% salidroside and/or 40-50% phenylpropanoids) has been taken by mouth three times daily.

For anxiety, 170 milligrams of rhodiola (Rhodax®; Phoenix Laboratories by Bodyonics Ltd.) has been taken by mouth twice daily for 10 weeks.

For bladder cancer, rhodiola extract of unknown dose has been taken by mouth for unknown duration.

For depression, 100-1,000 milligrams of rhodiola (standardized to 3% rosavins and 1% salidrosides) has been taken by mouth daily in 2-3 doses on an empty stomach. A dose of 340 milligrams daily (two tablets of SHR-5 once daily) and 680 milligrams (two tablets of SHR-5 twice daily) have been taken by mouth.

For exercise performance enhancement, the following doses have been taken by mouth: 50 milligrams of rhodiola extract (SHR-5) twice daily for 20 days; 100 milligrams of rhodiola (Rhodiolin, CaliVita International, United States), each capsule containing 100 milligrams of rhodiola concentrate and 5.0 milligrams of zinc, twice daily for four weeks; 200 milligrams of rhodiola extract, standardized to 3% rosavin and 1% salidroside, as an acute dose or once daily for four weeks; 3 milligrams per kilogram of body weight of rhodiola as an acute dose before exercise; and 340 milligrams of Rhodax® (Phoenix Lab; containing 30 milligrams of rhodiola) twice daily (morning and evening) for 30 days.

For fatigue, 144-576 milligrams of rhodiola (SHR-5 extract) has been taken by mouth daily for up to 28 days.

For hypoxia, rhodiola (dose unavailable) has been taken by mouth for seven days and for 24 days.

For lung disease (acute injury), 4 grams of rhodiola has been taken by mouth daily for 7-10 days before surgery and 5-7 days after surgery in patients with severe pulmonary hypertension undergoing cardiopulmonary bypass.

For mental performance during fatigue, the following doses have been taken by mouth: 100-1,000 milligrams of rhodiola (standardized to 3% rosavins and 1% salidrosides) daily in 2-3 doses on an empty stomach; 170 milligrams of rhodiola extract (SHR-5) daily for two weeks; an acute dose of 3 milligrams per kilogram body weight of rhodiola before exercise; 100-555 milligrams of rhodiola extract (SHR-5) daily for up to 20 days.

Children (under 18 years old)

There is no proven safe or effective dose for rhodiola in children.

For lung disease (acute injury), 2 grams of rhodiola has been taken by mouth daily for 7-10 days before surgery and 5-7 days after surgery in patients with severe pulmonary hypertension undergoing cardiopulmonary bypass.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid with known allergy or hypersensitivity to rhodiola, its constituents, or members of the Crassulaceae family.

Rhodiola may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Rhodiola may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Rhiodiola may affect the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Use cautiously in patients using CNS depressants, as rhodiola may increase the risk of CNS depression or cause sedation or drowsiness. Use caution if driving or operating heavy machinery.

Use cautiously in individuals with cardiovascular disease, based on unconfirmed reports that rhodiola may increase blood pressure, heart rate, and heart palpitations when taken in combination with other medications.

Use cautiously in individuals using agents metabolized by P-glycoprotein, as rhodiola has been found to be a potent inhibitor of this transport activity.

Use cautiously in individuals using antiarrhythmic agents.

Use cautiously in patients receiving immunosuppressants, as rhodiola may stimulate the immune system.

Use cautiously in patients using agents containing piperine, such as black pepper.

Avoid in patients using antidepressants (SSRIs, MAOIs); theoretically, concurrent use may increase the risk of adverse effects, including serotonin syndrome.

Avoid in patients with known allergy or hypersensitivity to rhodiola, its constituents, or members of the Crassulaceae family.

Avoid in pregnant or breastfeeding women, due to a lack of safety data.

Pregnancy and Breastfeeding

Avoid use in pregnant or breastfeeding women due to a lack of safety data.

Rhodiola may lower blood sugar levels. Caution is advised when using drugs that may also lower blood sugar. Patients taking drugs for diabetes by mouth or injection should be monitored closely by a qualified healthcare professional. Dosing adjustments may be necessary.

Rhodiola may alter blood pressure. Caution is advised in patients taking drugs that alter blood pressure, such as ACE inhibitors.

Rhodiola may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Rhodiola may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Use cautiously in patients using CNS depressants, as rhodiola may cause sedation or drowsiness. Use caution if driving or operating heavy machinery.

Rhodiola may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

Rhodiola may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Rhodiola may increase the amount of drowsiness caused by some herbs or supplements. Use caution if driving or operating heavy machinery.

Because rhodiola may contain estrogen receptor-interacting chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

Spasov AA, Wikman GK, Mandrikov VB, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine 2000;7(2):85-89.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.